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Not on formulary

Does Devoted Health require prior authorization for Synjardy?

Synjardy does not appear on any Devoted Health Medicare Part D formulary, so it is not covered under those plans. That is not the same as prior authorization being unnecessary.

The drug is absent from every formulary this payer files, so it is not covered — which is not the same as authorization being unnecessary.

  • This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm productPlans coveringRequire prior authStatus
empagliflozin 5 MG / metformin hydrochloride 500 MG Oral Tablet [Synjardy]16643210 / 4150Not on formulary
empagliflozin 12.5 MG / metformin hydrochloride 500 MG Oral Tablet [Synjardy]16643250 / 4150Not on formulary
empagliflozin 5 MG / metformin hydrochloride 1000 MG Oral Tablet [Synjardy]16643280 / 4150Not on formulary
empagliflozin 12.5 MG / metformin hydrochloride 1000 MG Oral Tablet [Synjardy]16653690 / 4150Not on formulary
24 HR empagliflozin 10 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Synjardy]18626880 / 4150Not on formulary
24 HR empagliflozin 12.5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Synjardy]18626920 / 4150Not on formulary
24 HR empagliflozin 25 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Synjardy]18626970 / 4150Not on formulary
24 HR empagliflozin 5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Synjardy]18627010 / 4150Not on formulary

Product names come from RxNorm (U.S. National Library of Medicine).

Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
Effective
2026-06-30
Retrieved
2026-07-19
SHA-256
e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Synjardy at other payers

Or see Synjardy across every payer at once.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.